US20080163872A1 - Device For Administering a Breathing Gas and Method For Adjusting Breathing Gas Pressures That Alternate at Least in Some Phases - Google Patents

Device For Administering a Breathing Gas and Method For Adjusting Breathing Gas Pressures That Alternate at Least in Some Phases Download PDF

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Publication number
US20080163872A1
US20080163872A1 US11/885,344 US88534406A US2008163872A1 US 20080163872 A1 US20080163872 A1 US 20080163872A1 US 88534406 A US88534406 A US 88534406A US 2008163872 A1 US2008163872 A1 US 2008163872A1
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Prior art keywords
breathing gas
pressure
gas pressure
point
parameter
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US11/885,344
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English (en)
Inventor
Claus Negele
Knut Jochle
Rainer Jakobs
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MAP Medizin Technologie GmbH
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MAP Medizin Technologie GmbH
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Assigned to MAP MEDIZIN-TECHNOLOGIE GMBH reassignment MAP MEDIZIN-TECHNOLOGIE GMBH ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: JOCHLE, KNUT, JAKOBS, RAINER, NEGELE, CLAUS
Publication of US20080163872A1 publication Critical patent/US20080163872A1/en
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0605—Means for improving the adaptation of the mask to the patient
    • A61M16/0633—Means for improving the adaptation of the mask to the patient with forehead support
    • A61M16/0638—Means for improving the adaptation of the mask to the patient with forehead support in the form of a pivot
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/085—Measuring impedance of respiratory organs or lung elasticity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0683—Holding devices therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3368—Temperature

Definitions

  • the invention is directed to a device for administering a breathing gas to a user.
  • the invention is also directed to a method for adjusting the static pressure, prevailing at the user, of the breathing gas to alternating pressure levels that in at least some phases are above the ambient pressure.
  • a breathing gas such as filtered ambient air
  • a breathing mask arrangement and a feeding device coupled to it.
  • a breathing gas pressure that is elevated above ambient pressure, typically in the range of from 4 to 18 mbar, it becomes possible to prevent any obstructions in the region of the upper airways.
  • the reduction in the likelihood that such obstructions will occur in the region of the upper airways during the administration of the breathing gas at an elevated pressure level is based on an effect known as pneumatic splinting.
  • This splinting effect is attained as such as a result of the pressure acting on the airway wall in the region of the upper airways and radially supporting this wall in the process.
  • the level of the pressure required to support obstruction-relevant portions of the airway depends on the physiological status of the user.
  • a pressure drop caused by the flow in inspiration because of these constrictions means that an external breathing gas pressure is required, by which adequate airway support is assured even after the inspiratory pressure drop caused by flow resistance in the obstruction-relevant zones is subtracted.
  • the expiratory phase because of the flow resistance of the airways, no drop in the supporting pressure is caused, so that in expiration, the tracking effect is as a rule still assured even at a lesser pressure.
  • the breathing gas pressures prevailing at the patient can be varied essentially synchronously with the respiration phases detected, such that in the inspiration phase, the breathing gas pressure is higher than in the expiratory phase.
  • the peak pressure level and the pressure level spacing are typically adapted during examination of the user in a sleep laboratory.
  • the breathing gas pressure can be guided in such a way that during the expiratory phases, lower breathing gas pressures prevail than during the inspiration phases. It is also possible to adapt the breathing gas pressure such that an elevated breathing gas pressure or an elevated level difference, for instance, is not regulated until a predetermined startup phase of a therapeutic device or a phase in which the user falls asleep is concluded, or if the person to be provided with breathing support is in a predetermined sleep stage.
  • the administration of the breathing gas at the pressure levels that are at least intermittently above the ambient pressure can be done via devices which besides a feeding device for feeding the breathing gas, typically formed by a blower, also include a control unit, by which the feeding power of the feeding device is adapted (for instance by regulating the rpm of the blower impeller).
  • This control unit can be embodied such that a desired pressure regulating characteristic is effected by means of essentially program-based definition of the configuration of the control unit.
  • a control unit equipped adequately in terms of computation power it becomes possible to implement relatively complex pressure regulating strategies and by observation of the breathing gas flow signal to draw conclusions about the instantaneous physiological status of the user, and/or to detect the phase of respiration and calculate different set-point pressure levels for the inspiration phase and for the expiratory phase.
  • the problem is that setting a pressure level that is advantageous from the standpoint of the mechanics of breathing or therapeutic standpoints or for preventing obstruction is sometimes perceived subjectively by the affected user as not optimal, or as burdensome or even unpleasant.
  • the object of the invention is to provide solutions which make it possible to guide the pressure in a way that is subjectively perceived by the user as pleasant or at least more acceptable, and which take improved account of the mechanics of breathing that are also definitive in terms of an intended therapeutic effect.
  • this object is attained by a device for furnishing or providing a breathing gas at alternating breathing gas pressure levels that at least in some phases are above the ambient pressure, having:
  • This nonlinear function is preferably a trigonometric function, or a function approximate to that with a pronounced nonlinear character.
  • the nonlinear function can be embodied as an arc tangent, sine/cosine, or root function.
  • a modulation argument in particular the ratio of the instantaneous breathing gas flow to a reference value can be used.
  • This reference value may be an extreme value of the breathing gas flow of the preceding breath, or a value calculated in some other way, preferably adaptively.
  • the average breathing gas flow of the most recent breath, or of a predetermined number of breaths, or of the breaths within a predetermined length of time is especially suitable.
  • the function is preferably defined such that after the expiration of a length of time lasting as long as a typical expiratory phase, the potential for pressure reduction is reduced, and is optionally set to zero.
  • the instantaneous or modelled thermal load of electrical components, or other types of components that set limit temperatures is considered.
  • the device states in which the device components do not yet have an impermissibly high thermal load, to implement highly dynamic regulation if needed. Only if less dynamic regulation is needed on the basis of temperature measurement values or other kinds of conclusions about the thermal load of the device, or if a more-restricted pressure regulation range appears recommended, can corresponding arguments of the pressure regulating function be designed by parameter adaptation, such that a lesser pressure variation potential prevails, or other kinds of lesser pressure variations occur.
  • the function intended for calculating the set-point pressure level is designed as a summation function, with at least one nonlinear member, or as a nonlinear function with an argument that takes the breathing gas flow into account.
  • the function can be designed such that both for breathing gas flows below a mean breathing gas flow value and for breathing gas flows above a mean breathing gas flow value, attenuated pressure reduction potentials result.
  • the pressure reduction potential can be extensively restricted, set to zero, or even optionally inverted, so that then a slight overelevation of pressure ensues, for instance as an inspiration trigger.
  • breathing gas flow should be understood in the present context to mean the shifted volume per unit of time dictated by respiration. Information about this can be obtained by suitable measurement means, such as differential pressure measurement baffles, dynamic pressure measuring arrangements, or other kinds of measuring arrangements suitable for detecting volumetric flows of gas. From a control standpoint, other kinds of information or signals indicative of the breathing gas flow can be evaluated, such as the electrical power drawn by the breathing gas feeding device.
  • the breathing gas flow, or signals representing it can also be obtained in other ways, in particular from the blower rpm and from the pressure gradient prevailing at the blower, in a characteristic-diagram- or map-based manner.
  • a value which as a result is permanently included in the flow signal and which may possibly also slightly vary with changing pressures, can be suitably taken into account, so that the flushing flow is not interpreted as respiration or as inspiration.
  • Ascertaining the flushing flow can be done by computer using suitable models, by forming an integral or a mean value, and is exhibited in the breathing gas flow signal in the form of an offset relative to a zero line.
  • the detection of the breathing phase can be done by evaluating the breathing gas flow signal, and in particular by evaluating its first derivation, with regard to the attainment of zero points or threshold values.
  • Different statements for respiration phase detection volume-, curvature-, and slope-based statements, as well as profile-based statements of other kinds) can be combined to enable the most reliable possible detection and discrimination among the respiration phases.
  • the range of variation of the breathing gas flow can be set into proportion using a suitable reference parameter, so that the variation of the breathing gas flow is within a standardized range, such as from 0 to 1 or from 0 to ⁇ ; the standardization thus achieved can be further mapped or plotted via a trigonometric function and used to calculate an instantaneous suitable pressure value.
  • the mapping function used in this respect to map the variation in the volumetric flow as a variation in the breathing gas pressure is preferably designed such that within a typical period of time for an expiration, in the range of mean values of the volumetric flow, relatively major pressure changes occur, while conversely the changes decrease with increasing volumetric flows.
  • mapping the expiratory volumetric flow as pressure reduction values.
  • the pressure can be defined for instance on the following statement:
  • p exp(v,t) stands for expiratory static breathing gas pressure.
  • p base stands for basic pressure, such as the recommended, static, inspiratory therapeutic pressure.
  • v stands for the breathing gas flow.
  • v max stands for the maximum breathing gas flow, optionally the average peak value.
  • k 2 is an adaptation factor.
  • T insp is the duration of the inspiration phase, optionally the average value of the preceding respiration cycles.
  • the invention is also directed to the pressure guidance method, which can be performed based on the apparatus of the invention, in general as well as in special features, such as those that result from the recited special apparatus provisions or indications of effects recited in other ways.
  • FIG. 1 a sketch for explaining a system according to the invention for delivering a breathing gas at pressure levels that alternate essentially synchronously with respiration;
  • FIG. 2 a sketch for explaining the nonlinear dependency of the breathing gas pressure on the instantaneous breathing gas flow
  • FIG. 3 a schematic illustration for explaining the regulation provisions provided for the pressure adaptation according to the invention
  • FIG. 4 a a sketch for explaining the makeup of a first variant of the function used for the pressure adaptation according to the invention
  • FIG. 4 b a sketch for explaining a further variant of the function used for the pressure adaptation
  • FIG. 5 a data sheet for explaining the pressure values generated using a function according to the invention
  • FIG. 6 a graph for illustrating the values of FIG. 5 ;
  • FIG. 7 a a summary, based on a graph, for explaining a function component f 1 of a further pressure guidance function
  • FIG. 7 b a summary, based on a graph, for explaining a further function component f 2 of a further pressure guidance function
  • FIG. 7 c a summary in formula form for illustrating the formation of the pressure guidance formula from the arguments f 1 and f 2 .
  • FIG. 1 shows a user 1 , on whom a breathing mask 3 is fixed via a headband arrangement 2 .
  • the breathing mask 3 in this example is embodied such that it covers the nose region but leaves the mouth region free. It is also possible to embody the breathing mask 3 such that it also covers the oral opening.
  • the deliver of breathing gas can also be done via other kinds of structures, such as mouth insert elements, or merely nose pads seated in the region around the nostrils.
  • the breathing mask 3 is connected to a device 6 for delivering the breathing gas (in this case, filtered ambient air) via a hose connection plug 4 and a flexible hose 5 .
  • the device 6 includes a feeding device, embodied here as a blower 7 , which communicates on the intake side with the environment via a suction line 8 and a suction filter device 9 .
  • the blower 7 is connected on the pressure side to a pressure line segment 10 .
  • the pressure line segment 10 leads, via a muffler segment, not illustrated in detail, to a hose connection stub 11 , to which the flexible hose 5 is detachably coupled.
  • the signal pickup device 12 for picking up signals indicative of the breathing gas flow.
  • the signal pickup device is embodied in collaboration with a measurement baffle arrangement, and the signal indicative of the breathing gas flow can be picked up in the form of a differential pressure signal, that is, the difference in the pressures upstream and downstream of the measurement baffle arrangement.
  • Signals indicative of the breathing gas flow can also be attained in other ways, for instance on the basis of detecting the motor power drawn, on the basis of acoustical effects, or for instance by means of an optical waveguide that is deflected in a way that is indicative of the flow of breathing gas moving past it.
  • the blower 7 may be embodied such that the differential pressure built up by the blower 7 between the suction line 8 and the pressure line segment 10 is adjustable by regulating the rpm of an impeller provided in the blower 7 . It is also possible to make other provisions for controlling or regulating the differential pressure that exists between the suction line 8 and the pressure line segment 10 . Such provisions may in particular take the form of bypass lines or provisions made inside the blower 7 .
  • the differential pressure prevailing between the suction line 8 and the pressure line segment 10 is adapted by means of regulating the rpm of an impeller of the blower 7 .
  • a drive device of the blower 7 is connected to a control unit 14 via a triggering line 13 .
  • the control unit 14 is preferably embodied such that the pressure regulating concept that is in the final analysis executed by this control unit 14 can be defined in a program-based way by storing suitable program data sets.
  • the control unit 14 is in particular preferably embodied such that by means of it, pressure regulating concepts adapted to the particular therapy intended can be implemented. These pressure regulating concepts can be stored directly in the control unit 14 in suitable memory units 15 .
  • control unit 14 It is also possible to embody the memory units 15 as replaceable units, so that the applicable control concept is furnished by means of inserting or docking a corresponding memory unit or circuit unit into or onto the control unit 14 . It is also possible to provide the control unit 14 with an interface device, so that the appropriate configuration of the control unit 14 can be brought about by way of temporary connection to a configuration system.
  • a data set is stored in the memory unit 15 , and by way of it an adaptation of the breathing gas pressure, applied to the user 1 via the breathing mask 3 , is done as defined by a pressure regulating concept that provides at least intermittently alternating pressure levels synchronously with respiration.
  • These pressure levels can be set in particular for an expiratory phase and optionally also for an inspiration phase, by recourse to a nonlinear pressure guidance function.
  • This nonlinear pressure guidance function is represented for instance as a three-dimensional function f that is dependent on the time t and the instantaneous breathing gas flow v.
  • this function f shown here as a function of the progression of time and of the instantaneous breathing gas flow during an expiratory phase, a pressure reduction and optionally a slight overelevation of pressure at the onset of an inspiration phase can both brought about.
  • the control unit 14 is furthermore embodied such that besides the signal indicative of the instantaneous breathing gas flow and picked up via the signal pickup device 12 , it also takes into account the instantaneously set breathing gas pressure as well as the actually prevailing thermal load, calculated via a model statement, of certain components of the device 6 .
  • control unit 14 may be configured such that until a limit value thermal load of the device 6 is reached, the breathing gas pressure regulation is done with relatively highly dynamic regulation, or via a relatively wide pressure variation range. This makes it possible in particular, in a phase when a patient is going to sleep, to attain especially comfortable pressure regulation while fully utilizing the pressure regulation spectrum.
  • the control unit may be embodied such that first, in the form of a standard configuration, it makes a preferably largely overswing-free regulation of a therapeutic pressure (such as CPAP pressure) intended for the user possible.
  • a therapeutic pressure such as CPAP pressure
  • control unit 14 configured for executing more-complicated pressure control concepts.
  • This special configuration can be made such that the control unit 14 is expanded with a control module intended for more-complex calculation of a set-point pressure signal, so that as interface information, only the set-point pressure required by the control module is exchanged.
  • the set-point pressure it is possible to take properties of specific devices into account, in particular the transmission behavior of the blower 7 , so that by means of the specification of the set-point pressure signal, certain transmission properties of the system are already taken into account.
  • the set-point pressure signal does not correspond to the pressure that is to be finally regulated, but rather to a controlling variable required in advance to attain a required pressure.
  • FIG. 2 shows, it becomes possible, on the basis of the configuration according to the invention of the control unit 14 , particularly by defining the regulation strategy of the control unit 14 by means of the data set stored in the memory unit 15 , to set breathing gas pressure levels that at least in some phases alternate synchronously with respiration.
  • a pressure reduction that is nonlinear with respect to the breathing gas flow is attained during the expiratory phase, based on the function according to the invention.
  • the breathing cycle 2 shown here because of the adaptation of the pressure guidance function, nonproportional and markedly nonlinear relations result between the pressure reduction and the instantaneous breathing gas flow.
  • the result is a further-changed nonproportional, nonlinear relationship between the breathing gas flow and the reduction in pressure during the expiratory phase.
  • FIG. 3 serves to illustrate the closed control loop provided according to the invention for adapting the static pressure P, applied to the patient, of the breathing gas.
  • This breathing gas pressure is built up by means of the blower 7 .
  • the feeding power of the blower 7 is adapted by means of a control module m 1 .
  • This control module m 1 can form part of a closed control loop with a view to a feedback of the pressure signal P.
  • a pressure specification signal SP can be delivered to the pressure control module m 1 by means of a pilot control module m 2 .
  • the pilot control module m 2 may be embodied such that by means of it, a set-point value, specified by a pressure specification module m 3 , is generated in a pressure control signal SP that can advantageously be processed in terms of the transmission behavior of the closed control loop that includes the control module m 1 .
  • the control units shown here as discrete modules m 1 , m 2 , m 3 , can all be realized, in program-based and intermeshed form, in a single computer device.
  • control module m 1 it is also possible to form the control module m 1 such that it is a component of a standard or basic device which permits various possibilities for generating the pressure specification signal SP.
  • the pressure specification signal SP can be adjusted by the user using a simple input device.
  • control unit 14 In the case of retrofitting or equipping the device 6 , the configuration of the control unit 14 or of the control unit 15 can be varied in a program-based way. It is also possible to equip the control unit 14 with additional signal- or data-processing or data storage medium hardware, in order to furnish the control pressure signal SP.
  • a signal indicative of the instantaneous breathing gas flow which can be obtained for instance via the signal pickup device 12 shown in FIG. 1 , is processed.
  • information about the instantaneous thermal load of the device 6 and the pressure p applied to the patient at that moment as well as time information can be processed.
  • the time information and optionally also the information about the thermal state of the device can be furnished directly in the module m 3 by means of clocking or timer devices.
  • the thermal load can also be detected by means of temperature detecting devices provided in the region of the device 6 , or also via a model statement in the region of the module m 3 .
  • the thermal load of the device 6 For detecting the thermal load of the device 6 or for estimating the thermal load, it is also possible to evaluate other information or signals that can be picked up in the region of the device. In particular, it is possible to ascertain information about the power drawn by the blower for ascertaining the thermal load of the blower motor, or to ascertain the power stage provided for triggering the blower motor. Such information can be obtained from the pressure specification signal SP, the intermediate results generated to attain the pressure specification signal SP, or signals for triggering the power stage.
  • the control module m 1 can be embodied such that it triggers a blower motor such that the blower motor causes the impeller coupled with it to rotate at a speed at which a required breathing gas pressure is achieved.
  • the changes in the blower rpm can be set by means of a defined setting of the power delivered to the driving motor.
  • it is possible optionally, via the control module m 1 to operate the motor such that by it, a braking moment that temporarily brakes the impeller device or the masses otherwise moved is generated.
  • Corresponding concepts for varying the breathing gas pressure may optionally be selected as a function of the instantaneous thermal load on the feeding device or an associated power stage. For instance, in device states in which a high thermal load or an at least estimated high thermal load prevails, it is possible in particular to make the pressure changes or rpm changes of the impeller device of the blower in such a way that an Impermissibly great further increase in the thermal load is not to be expected.
  • a corresponding control structure such as a bypass valve or other kind of control device, can be triggered.
  • the nonlinear function, executed according to the invention in the region of the pressure specification module m 3 , for ascertaining an outcome that is definitive for the pressure applied to the patient can be embodied such that it has a plurality of arguments A 1 , A 2 , . . . , AN linked together by means of operators O 1 , O 2 .
  • the argument A 1 may be trigonometric function, in particular, a sine, cosine or arc tangent function, whose angular or axial increment takes into account a parameter that reflects the instantaneous breathing gas flow v.
  • a timing circuit can be realized by which a desired attenuation of the effects of the argument A 1 is made possible with increasing progression of time, in particular the time that has progressed since the end of the preceding inspiration phase.
  • the argument AN can serve to reflect the instantaneously prevailing thermal load of the device, or the estimated thermal load of the device.
  • the operators O 1 , O 2 can be realized in particular as multiplication operators.
  • the entire pressure guidance function, realized by means of the arguments A 1 , A 2 , . . . , AN and the associated operators O 1 , O 2 , . . . , ON can optionally be broken down into a series and executed with adequate approximation in the region of the pressure specification module m 3 .
  • the argument A 1 such that it reflects a predetermined nonlinear relationship between the instantaneous breathing gas pressure and the instantaneously prevailing, expiratory breathing gas flow.
  • the argument AN can be linked functionally to the argument A 1 via the operator O 2 , particularly with O 2 as a multiplier. It is also possible to incorporate the argument AN, as a further increment of the argument A 1 , into the function intended for specifying the breathing gas pressure.
  • FIG. 5 shows a pressure curve, on the basis of a nonlinear function of the makeup shown in FIG. 4 a , in which the arguments A 1 and A 2 are represented by arc tangent functions, and the operator O 1 is a multiplier.
  • FIG. 6 shows a therapeutic pressure calculated on the basis of the function indicated.
  • the therapeutic pressure is kept at a predetermined value, here for instance shown as 20 mbar.
  • the therapeutic pressure is reduced; the reduction is correlated in a nonlinear way with the breathing gas flow that prevails during the expiratory phase.
  • the breathing gas pressure p required is found from the pressure guidance function shown in FIG. 7 c.
  • the present invention can be used as described below:
  • a breathing gas delivery system is made available to the patient that includes a basic device, an air humidifier, a hose, and a breathing mask arrangement.
  • the basic device is connected to a configuration system via an interface device and configured to suit the patient in the area of the sleep laboratory.
  • a configuration system via an interface device and configured to suit the patient in the area of the sleep laboratory.
  • the patient can then use the thus-configured device at home.
  • the device according to the invention is distinguished in that the breathing gas pressure is adjusted largely in alternation, synchronously with the breathing.
  • the breathing gas pressure is adjusted on the specification of a pressure guidance value, which is calculated by means of a nonlinear relationship between the time t that has elapsed since the end of the preceding expiratory phase and the instantaneous breathing gas flow. If the thermal status of the device could become critical in terms of regulating the feeding power of the feeding device in a way that requires a relatively large amount of power, then the regulating strategy can automatically be modified, taking actual or estimated load figures into account, with the goal of pressure guidance that draws reduced power or that releases less heat.

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US11/885,344 2005-03-04 2006-03-06 Device For Administering a Breathing Gas and Method For Adjusting Breathing Gas Pressures That Alternate at Least in Some Phases Abandoned US20080163872A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DE102005010488A DE102005010488A1 (de) 2005-03-04 2005-03-04 Vorrichtung zur Verabreichung eines Atemgases und Verfahren zur Einstellung zumindest zeitweise alternierender Atemgasdrücke
DE102005010488.6 2005-03-04
EPPCT/EP2006/002036 2006-03-06
PCT/EP2006/002036 WO2006094744A2 (en) 2005-03-04 2006-03-06 Device for administering a breathing gas and method for adjusting breathing gas pressures that alternate at least in some phases

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WO2006094744A3 (en) 2007-01-18
AU2006222213A1 (en) 2006-09-14
DE102005010488A1 (de) 2006-09-07

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